Restricting access to opioids for those who need them to get out of bed each morning is not effective policy.
Forty-three years ago, a truck ran a red light and totaled my car. Nothing was broken but I was never the same. I had to stop working. Most of the damage was in my back and neck. That was followed by another car accident, and then domestic violence. I’ve ended up with degenerative disc disease, protruding disc, stenosis, and I’m working on becoming bionic since I’ve had most of my joints fully replaced.
When I take pain medication, I do so responsibly by following directions. I do not drink alcohol. I do not “get high” or experience euphoria. It merely enables me to move and function. Perhaps I had to reach age seventy-two before learning some valuable survival skills. There is strong concern in the pain management community about legislation forcing people with chronic or intractable pain to lower their dosage of opioid medication. It has begun in other states which include, Oregon, California, Montana, Nevada and Utah.
The subject has come to Colorado. The website for Healthcare Policy and Finance (HCPF), which directs the Medicaid program is called At a Glance. There has been a recent change to the opioid policy: the former policy, created October 1, 2017 allowed for a daily opioid dosage of 250 MME (Morphine Milligram Equivalent). The new policy, effective November 15, 2018, lowers the maximum to 200 MME. (MME is a calculation of the total daily dosage of all opioid drugs.) Exceptions will be identified for certain cases and persons with disabilities may be granted a one-year authorization approval following a consultation – at no additional charge to the patient–with a Health First Colorado pain management specialist and the patient’s provider.
This raises the concern that a medical specialist who doesn’t really know the patient will determine the best treatment options, rather than a doctor or medical provider.
There are unique classes of patients who rely on the use of controlled medications. Given the severity of the pain from their illnesses or injuries, some will die by inadvertent overdoses, by their own hands, or by natural causes. There are many others who will thrive (like me) – even at higher doses.
Chronic pain is usually defined as pain lasting over three months. According to The National Pain report, there are over 40 million people – over 18% of the US adult population–suffering from debilitating pain. That does not include patients experiencing acute or moderate pain (not impacting activities of daily living). In states that have implemented reduced opioid policies, it has forced people with severe pain to cut back or eliminate pain medication. There are many social and biological factors that aren’t being considered in this debate.
Some people have chosen suicide rather than living with chronic pain.
The FDA (Food and Drug Administration), CDC (Centers for Disease Control), and the DEA (Drug Enforcement Agency) have raised concerns about the use and abuse of opioids. I believe this has created a backlash for patients who rely on these medications and use them safely and properly. The authorities must balance the need for continued opioid access to persons who rely on opioids for continuous pain relief while addressing the ongoing concerns about safe use and abuse.
Forced policies have had limited success; whether the subject is alcohol and prohibition, marijuana, the government’s war on drugs, or mental health and forced treatment. If you or a loved one are affected by this latest dosage policy change, consider attending a meeting in January 2019 that will determine what people who have chronic pain choose as their response to this new policy. There will be rallies across the nation that will focus on policies that don’t punish pain patients. We need to decide how people living in Colorado will respond.
What do you think?
Please contact Christina Johnson – CLICK HERE
The opinions in this article are the author’s, and do not necessarily represent the views of the Colorado Senior Lobby.
Article by Christina Johnson
Board Member: Colorado Senior Lobby
Email – CLICK HERE
Christina Johnson is a member of the Colorado Commission on Aging, CSL Board Member, member of the CSL Legislative Committee and a member of the CSL Capitol Gang.